General Oral Health Topics

Does mercury in the silver fillings in your mouth pose any long-term health risks? Does fluoride, in spite of everything we’ve been told since childhood, actually cause more harm than good? What does the latest research reveal about tobacco use on your overall oral health?

This section is dedicated to the latest information about these and other oral health topics, pulled from authoritative sources such as the American Dental Association.

Flouride

For decades, fluoride has been held in high regard by the dental community as an important mineral that strengthens tooth enamel, which thereby helps to prevent decay of tooth structures.

Water fluoridation is endorsed by nearly every major health and safety-related organization in the world. Communities make it a common practice to “fluoridate” their drinking supplies in order for the general population to benefit from this inexpensive and effective preventative treatment.

Bottled water, home water treatment systems, and fluoride exposure

Can the consistent use of bottled water result in individuals missing the benefits of optimally fluoridated water? Can home water treatment systems (e.g., water filters) affect optimally fluoridated water supplies? The answer is yes to both. Read how you can avoid some of the pitfalls that may be preventing you from getting the maximum value of fluoride, in this article from the American Dental Association.

ADA statement on FDA toothpaste warning labels

The American Dental Association`s Council on Scientific Affairs believes that one part of the warning now required on fluoride toothpastes by the Food and Drug Administration (FDA) could unnecessarily frighten parents and children, and that the label greatly overstates any demonstrated or potential danger posed by fluoride toothpastes. The label language, “If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately,” is now required on all fluoride toothpastes. But the ADA, in a letter sent to the FDA last year, pointed out that a child could not absorb enough fluoride from toothpaste to cause a serious problem and that the excellent safety record on fluoride toothpaste argues against any unnecessary regulation.

Enamel fluorosis

According to the American Academy of Pediatric Dentistry, a child may face a condition called enamel fluorosis if he or she receives too much fluoride during the years of tooth development. Too much fluoride can result in defects in tooth enamel.

CDC web site provides information on community water fluoridation

People seeking information on whether their water system is fluoridated can now find out by visiting a new Web site at the Centers for Disease Control and Prevention (CDC). The new feature, “My Water`s Fluoride,” allows consumers in participating states to check out basic information about their water system, including the number of people served by the system and the target fluoridation level. Optimal levels recommended by the U.S. Public Health Service and CDC for drinking water range from 0.7 parts per million (ppm) for warmer climates, to 1.2 ppm for cooler climates accounting for the tendency to drink more water in warmer climates. States that are currently participating include Arizona, Colorado, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Maine, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, Nevada, North Dakota, Oklahoma, Pennsylvania and Wisconsin.

Preventive Program

Both natural teeth and teeth with restorations survive best in an oral environment that is clean and where the intake of harmful foods is controlled. Our program is designed to help prevent new cavities, preserve teeth that have been restored and manage periodontal disease. At the initial visit oral hygiene instructions are reviewed and are reinforced at subsequent recall visits. The following are helpful recommendations:

Brush your teeth twice a day in a circular motion with a soft bristled toothbrush aimed at the gum.

Floss every night in an up-and-down motion while keeping the floss in a U-shape and against the tooth surface.

Avoid smoking.

Avoid sticky sugary foods.

Eat a balanced diet.

Use antiseptic and fluoride rinses as directed.

Have sealants placed on young permanent teeth.

Fillings

Frequently asked questions: dental fillings

Are dental amalgams safe? Is it possible to have an allergic reaction to amalgam? Is it true that dental amalgams have been banned in other countries? Is there a filling material that matches tooth color? If my tooth doesn’t hurt and my filling is still in place, why would the filling need to be replaced? Read this interesting and informative discussion from the American Dental Association.

FDA consumer update: dental amalgams

The Food and Drug Administration and other organizations of the U.S. Public Health Service (USPHS) continue to investigate the safety of amalgams used in dental restorations (fillings). However, no valid scientific evidence has shown that amalgams cause harm to patients with dental restorations, except in rare cases of allergic reactions.

ATSDR – public health statements: mercury

The Centers for Disease Control and Prevention offers some scientific background on mercury (contained within silver-colored fillings), and whether it believes the substance presents any health hazards.

Analysis reveals significant drop in children’s tooth decay

Children have significantly less tooth decay in their primary (baby) and permanent teeth today than they did in the early 1970s, according to the Journal of the American Dental Association (JADA). The analysis reveals that among children between the ages of six and 18 years, the percentage of decayed permanent teeth decreased by 57.2 percent over a 20-year period. In addition, children between the ages of two and 10 years experienced a drop of nearly 40 percent in diseased or decayed primary teeth.

Alternative Materials

Advances in modern dental materials and techniques increasingly offer new ways to create more pleasing, natural-looking smiles. Researchers are continuing their often decades-long work developing esthetic materials, such as ceramic and plastic compounds that mimic the appearance of natural teeth. As a result, dentists and patients today have several choices when it comes to selecting materials used to repair missing, worn, damaged or decayed teeth.

The advent of these new materials has not eliminated the usefulness of more traditional dental restoratives, which include gold, base metal alloys and dental amalgam. The strength and durability of traditional dental materials continue to make them useful for situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth.

Alternatives to amalgam, such as cast gold restorations, porcelain, and composite resins are more expensive. Gold and porcelain restorations take longer to make and can require two appointments. Composite resins, or white fillings, are esthetically appealing, but require a longer time to place.

Here’s a look at some of the more common kinds of alternatives to silver amalgam:

Composite fillings – Composite fillings are a mixture of acrylic resin and finely ground glasslike particles that produce a tooth-colored restoration. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be “bonded” or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth. In teeth where chewing loads are high, composite fillings are less resistant to wear than silver amalgams. It also takes longer to place a composite filling.

Ionomers – Glass ionomers are tooth-colored materials made of a mixture of acrylic acids and fine glass powders that are used to fill cavities, particularly those on the root surfaces of teeth. Glass ionomers can release a small amount of fluoride that help patients who are at high risk for decay. Glass ionomers are primarily used as small fillings in areas that need not withstand heavy chewing pressure. Because they have a low resistance to fracture, glass ionomers are mostly used in small non-load bearing fillings (those between the teeth) or on the roots of teeth. Resin ionomers also are made from glass filler with acrylic acids and acrylic resin. They also are used for non-load bearing fillings (between the teeth) and they have low to moderate resistance to fracture. Ionomers experience high wear when placed on chewing surfaces. Both glass and resin ionomers mimic natural tooth color but lack the natural translucency of enamel. Both types are well tolerated by patients with only rare occurrences of allergic response.

Porcelain (ceramic) dental materials – All-porcelain (ceramic) dental materials include porcelain, ceramic or glasslike fillings and crowns. They are used as inlays, onlays, crowns and aesthetic veneers. A veneer is a very thin shell of porcelain that can replace or cover part of the enamel of the tooth. All-porcelain (ceramic) restorations are particularly desirable because their color and translucency mimic natural tooth enamel. All-porcelain restorations require a minimum of two visits and possibly more. The restorations are prone to fracture when placed under tension or on impact. Their strength depends on an adequate thickness of porcelain and the ability to be bonded to the underlying tooth. They are highly resistant to wear but the porcelain can quickly wear opposing teeth if the porcelain surface becomes rough.

Sealants

Research has shown that almost everybody has a 95 percent chance of eventually experiencing cavities in the pits and grooves of their teeth.

Sealants were developed in the 1950s and first became available commercially in the early 1970s. The first sealant was accepted by the American Dental Association Council on Dental Therapeutics in 1972. Sealants work by filling in the crevasses on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years. In fact, research has shown that sealants actually stop cavities when placed on top of a slightly decayed tooth by sealing off the supply of nutrients to the bacteria that causes a cavity.

Sealants act as a barrier to prevent bacteria and food from collecting and sitting on the grooves and pits of teeth. Sealants are best suited for permanent first molars, which erupt around the age of 6, and second molars, which erupt around the age of 12.

Sealants are most effective when applied as soon as the tooth has fully come in. Because of this, children derive the greatest benefit from sealants because of the newness of their teeth. Research has shown that more than 65% of all cavities occur in the narrow pits and grooves of a child`s newly erupted teeth because of trapped food particles and bacteria.

Application

Sealant application involves cleaning the surface of the tooth and rinsing the surface to remove all traces of the cleaning agent. An etching solution or gel is applied to the enamel surface of the tooth, including the pits and grooves. After 15 seconds, the solution is thoroughly rinsed away with water. After the site is dried, the sealant material is applied and allowed to harden by using a special curing light.

Sealants normally last about five years. Sealants should always be examined at the child`s regular checkup. Sealants are extremely effective in preventing decay in the chewing surfaces of the back teeth.

Insurance coverage for sealant procedures is increasing, but still minimal. Many dentists expect this trend to change as insurers become more convinced that sealants can help reduce future dental expenses and protect the teeth from more aggressive forms of treatment.

Infection Control

Standards and Best Practice

With all of the increased media attention on infection outbreaks such as AIDS and multi-drug resistant strains of viruses, it’s no wonder people have heightened concerns about infection control during a medical procedure.

Gloves, gowns and masks are required to be worn in all dentist offices today—a far cry from just a few decades ago—when fewer than one-third of all dentists even wore such personal protective equipment, or PPE. After each patient visit, disposable PPE-such as gloves, drapes, needles, and scalpel blades-are thrown away, hands are washed, and a new pair of gloves used for the next patient.

All hand instruments used on patients are washed, disinfected and/or sterilized with chemicals or steam after each use.

One of the most effective methods for preventing disease transmission—washing one’s hands—is practiced in our office. It is routine procedure to wash hands at the beginning of the day, before and after glove use, and after touching any surfaces that may have become contaminated.

Water Quality and Biofilms

Concerns about the quality of water used in a dentist’s office are unfounded, provided the dentist follows the infection control guidelines of the Centers for Disease Control and the American Dental Association.

Some health “experts” in recent years have called into question the risks associated with so-called “biofilms,” which are thin layers of microscopic germs that collect on virtually any surface. Essentially, these bacteria and fungi occur everywhere, including faucets in your home; your body is no less accustomed to being exposed to them than in any other situations.

In fact, no scientific evidence has linked biofilms with disease. If you have a compromised or weakened immune system, you are susceptible to germs everywhere. Consequently, let our office know if you have such a condition so additional precautions, if any, can be taken.

Medication and Heart Disease

Certain kinds of medications can have an adverse effect on your teeth.

Long ago, children exposed to tetracycline developed tooth problems, including discoloration, later in life. The medication fell out of use, however, and is not an issue today.

The best precaution is to ask your family physician if any medications he or she has prescribed can have a detrimental effect on your teeth or other oral structures.

A condition called dry mouth is commonly associated with certain medications, including antihistamines, diuretics, decongestants and pain killers. People with medical conditions, such as an eating disorder or diabetes, are often plagued by dry mouth. Other causes are related to aging (including rheumatoid arthritis), and compromised immune systems. Garlic and tobacco use are other known culprits.

Dry mouth occurs when saliva production drops. Saliva is one of your body’s natural defenses against plaque because it acts to rinse your mouth of cavity-causing bacteria and other harmful materials.

Some of the less alarming results of dry mouth include bad breath. But dry mouth can lead to more serious problems, including burning tongue syndrome, a painful condition caused by lack of moisture on the tongue.

If dry mouth isn’t readily apparent, you may experience other conditions that dry mouth can cause, including an overly sensitive tongue, chronic thirst or even difficulty in speaking.

Heart Disease

Medical research has uncovered a definitive link between heart disease and certain kinds of oral infections such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors such as tobacco use.

A condition called chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.

In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That’s why it’s critical to practice good oral hygiene to keep infections at bay—this includes a daily regimen of brushing, flossing and rinsing.

Antibiotic Prophylaxis

In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.

It is possible for bacteria from your mouth to enter your bloodstream during a dental procedure in which tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection.

However, certain cardiovascular conditions in patients with weakened hearts could be at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.

Latex Allergy

Naturally occurring latex has been linked in recent years to allergic reactions in people who use such products as latex gloves. The proteins in the latex, which can also become airborne, can cause problems in vulnerable people such as breathing problems and contact dermatitis. Some allergic reactions, including anaphylactic shock, have been more severe.

Many health experts have rightly attributed the dramatic increase of allergic reactions to latex in the health care community to the increased use of gloves and other personal protection equipment in light of the AIDS epidemic.

Latex is a pervasive substance in many household items—from toys and balloons to rubber bands and condoms.

Latex allergies could cause the following symptoms:

Dry skin

Hives

Low blood pressure

Nausea

Respiratory problems

Tingling sensations

People with high-risk factors for latex allergy include those who have undergone multiple surgical operations, have spina bifida, or are persistently exposed to latex products.

If you are vulnerable to latex or have allergies related to it, please notify our office and, by all means, seek medical attention from your family physician.

Age and Oral Health

Oral changes with age

Is tooth loss inevitable in your later years? How much should adults be concerned about cavities? Here you will find helpful answers to some frequently asked questions about oral health questions you may have as you get older.

Baby boomers looking for the warning signs of adult-onset diseases may be overlooking key symptoms in their mouth that should signal alarms about their overall health. According to a survey commissioned by the Academy of General Dentistry, 63 percent of baby boomers (ages 45-64) with an oral symptom considered to be a key indicator of a more serious health condition, were unaware of the symptom`s link to the condition. Boomers` failure to recognize that oral health holds valuable clues could negatively impact their overall health.

Tobacco

Dentistry health care that works: tobacco

The American Dental Association has long been a leader in the battle against tobacco-related disease, working to educate the public about the dangers inherent in tobacco use and encouraging dentists to help their patients break the cycle of addiction. The Association has continually strengthened and updated its tobacco policies as new scientific information has become available.

Frequently asked questions: tobacco products

What effects can smoking have on my oral health? Are cigars a safe alternative to cigarettes? Are smokeless tobacco products safe? The American Dental Association has some alarming news that you should know.

Smoking and Implants

Recent studies have shown that there is a direct link between oral tissue and bones loss and smoking.

Tooth loss and edentulism are more common in smokers than in non-smokers. In addition, people who smoke are more likely to develop severe periodontal disease.

The formation of deep mucosal pockets with inflammation of the peri-implant mucosa around dental implants is called peri-implantitis. Smokers treated with dental implants have a greater risk of developing peri-implantitis. This condition can lead to increased resorption of peri-implant bone. If left untreated, peri-implantitis can lead to implant failure. In a recent international study, smokers showed a higher score in bleeding index with greater peri-implant pocket depth and radiographically discernible bone resorption around the implant, particularly in the maxilla.

Many studies have shown that smoking can lead to higher rates of dental implant failure. In general, smoking cessation usually leads to improved periodontal health and a patient’s chance for successful implant acceptance.

Oral Piercing

Oral piercings (usually in the tongue or around the lips) have quickly become a popular trend in today’s society. With this popular trend, it is important to realize that sometimes even precautions taken during the installation of the piercing jewelry are not enough to stave off harmful, long-term consequences such as cracked or chipped teeth, swelling, problems with swallowing and taste, and scars. There is also a possibility of choking on a piece of dislodged jewelry, which makes it important to ask if the risks are warranted.

One of the most serious long-term health problems that may occur from oral piercings come in the form of damage to the soft tissues such as the cheeks, gums and palate, as well as opportunistic infections. When performed in an unsterile environment, any kind of body piercing may also put you at risk of contracting deadly infectious diseases such as HIV and hepatitis.

A tongue piercing is a common form of body piercing. However, tongue piercings have been known to cause blocked airways (from a swollen tongue). In some cases, a tongue piercing can cause uncontrolled bleeding.

General Dentistry

The first line of defense against oral health problems

In general dentistry, the dentist is the primary care provider for patients of all ages and is responsible for the prevention, diagnosis and treatment of a wide variety of conditions, disorders and diseases affecting the teeth, gums and maxillofacial (jaw and face) parts of the body. Even though general dentists primarily provide preventative care and minor restorative therapy, they are often able to perform a wide array of other dental procedures, including some minor cosmetic treatments.

The American Dental Association (ADA) recommends that patients visit their general dentist at least once every six months to ensure proper oral health and functionality. Regular oral health check-ups and maintenance help to prevent the development of serious dental problems that may require more extensive and costly treatments. General dentists are highly educated and trained in multiple facets of dentistry, providing a variety of different services for you and your family including:

Crowns and bridges

Dentures

Dental implants

Gum disease (Periodontal) treatment

Orthodontics

Root canal therapy

Teeth cleanings

Bonding

Dental fillings

General dentists who do not perform a certain treatment will provide you with a specialist referral.